Tuberculosis – The Singapore Experience, 1867–2018

“Forward-looking and successful in many ways, Singapore is nevertheless grappling with the difficult issue of tuberculosis like many countries around the world. Like these countries, Singapore also has a long and largely uncharted history of tuberculosis and tuberculosis control.”

Tuberculosis – The Singapore Experience, 1867–2018: Disease, Society and the State traces the policy and social history of tuberculosis in Singapore from the mid-nineteenth century to the present day. The 9-chaper book, funded by Infectious Diseases Programme grant from Saw Swee Hock School of Public Health (SSHSPH), charts the relationship between disease, society and the state, outlining the struggles of colonial and post-colonial governments to cope with widespread disease and to establish effective public health programmes and institutions.

When tuberculosis arrived in Singapore in the nineteenth century, the colonial administration viewed it as a “Chinese” sickness linked to the poverty, housing and insanitary habits of the Chinese working class. After the Second World War, the returning colonial government initiated ambitious medical initiatives and urban improvement schemes to improve the living conditions of the populace. These initiatives and schemes were carried on and improved upon by the post-colonial government, and efforts continue today to combat the resurgence of tuberculosis and the rise of microbial resistance.

Throughout, the book highlights the special difficulties of Singapore as an open port city with a large multicultural population, discusses the development of specific government and non-governmental institutions (especially the Singapore Anti-Tuberculosis Association), and describes people’s varied experiences, responses and resistance to the disease.

Written by Dr Loh Kah Seng and Assoc Professor Hsu Li Yang, it attempts to combine the disciplines of history and medicine. 

Dr Loh is a historian of Singapore and Honorary Research Fellow at the University of Western Australia. He is the author of Squatters into Citizens: The 1961 Bukit Ho Swee Fire and the Making of Modern Singapore (NUS Press, 2013). He also researches the rich and varied heritage of Singapore – housing, industrial, culinary, and medical.

Assoc Professor Hsu is a Singaporean infectious diseases physician by training who has spent the past decade performing research and caring for patients with drug-resistant infections, including tuberculosis. He is currently head of the infectious diseases and Cambodia research programmes at the SSHSPH, National University of Singapore. In recent COVID-19 outbreak, he works to facilitate collaborative research between his colleagues and other researchers in Singapore to better understand the virus, and to address the secondary public health issues caused by it. He is regularly consulted by media for expert views on Covid-19. 

Sunil Amrith, Professor at the Department of History, Harvard University, succinctly summarised the importance of this book as follows: “This fascinating and absorbing book by Kah Seng Loh and Li Yang Hsu is a classic in the social history of medicine. Drawing on a broad range of archival sources, including vivid patients’ accounts, the authors use the history of tuberculosis control in Singapore as a way to highlight key themes in the city-state’s social and political history, including the development of the state and the shifting lines of social and economic inequality.  This book will be of interest to scholars of health and society around the world as a richly detailed case study that is sure to illuminate wider comparisons. As a collaboration between a social historian and a physician who specialises in infectious disease, it is also a model of interdisciplinary scholarship.”

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